Causes of Alopecia: Why Hair Falls Out

Causes of Alopecia: Why Hair Falls Out

Hair loss has many causes, and the right treatment depends entirely on which one is at work. "Alopecia" simply means hair loss - it is a sign, not a single disease.

The Common Causes

• Androgenetic alopecia (pattern baldness): the most common cause in both men and women - genetic sensitivity of follicles to DHT hormone. Receding temples and crown in men; widening parting in women.
• Telogen effluvium: diffuse shedding 2-3 months after a shock - high fever (classically after dengue, typhoid, COVID), surgery, childbirth, crash dieting, or severe stress. Usually temporary.
• Alopecia areata: an autoimmune attack producing smooth, round, totally bare patches. Can affect any hair-bearing skin.
• Nutritional: iron deficiency (very common in Indian women), low protein, low vitamin D, B12, and zinc.
• Thyroid disorders, PCOS, and other hormonal states.
• Traction and styling damage: tight braids, turbans, chemical straightening, heat.
• Fungal scalp infection (tinea capitis), especially in children.
• Medicines: chemotherapy, some blood thinners, retinoids, and others.

When It Needs a Doctor

Sudden patches, loss with itching or scaling, eyebrow or body-hair loss, or shedding with fatigue, weight change, or irregular periods - these signal causes that need diagnosis, not oils, per NHS hair loss guidance.

The Classical View of Causes

Ayurveda's hair-loss chapter is surprisingly specific. The classics (Ashtanga Hridaya, Sushruta Samhita) describe Khalitya (gradual balding) as primarily a Pitta-led disorder - excess internal heat, aggravated by spicy, sour, salty, and fermented food, burning the follicle field - with Vata drying the scalp and Kapha blocking the channels. Indralupta (sudden patchy loss) is described as a deeper Pitta-Rakta disturbance. Classical nidana lists also include suppression of natural urges, excess sun exposure, dust, and - notably - Atiprajagara (chronic loss of sleep) and Shoka (grief and chronic stress), which maps well onto telogen effluvium's stress trigger.

These are interpretive frameworks: classical "Pitta heat" cannot diagnose your iron level or your thyroid. But the classical instinct - hair fall as a whole-body signal worth investigating, not just a scalp problem - is exactly right.

Frequently Asked Questions

Is hair fall always genetic? No. Pattern baldness is genetic, but shedding after illness, childbirth, or stress is common and often reversible - which is why diagnosis comes first.

Can dandruff cause baldness? Dandruff itself does not destroy follicles, but severe untreated seborrhoeic dermatitis and scratching can worsen shedding. Treat it.

Does hard water cause hair loss? Hard water roughens the hair shaft and irritates some scalps, but it does not kill follicles - the evidence for true hair loss from water is weak.

Can stress alone cause bald patches? Severe stress triggers diffuse shedding (telogen effluvium); smooth bare patches are alopecia areata - autoimmune, and worth a dermatologist visit.